First of all, let me start off by saying: I have no negative feelings about the evaluation or Early Intervention. I love Early Intervention! I wasn’t dreading the evaluation or hoping they would tell me she wouldn’t need therapy. Quite the contrary, I was hoping she’d qualify! Anyway, I’m not sure that came across in my last post, so I just wanted to clarify.
Some additional background- you don’t need a referral for Early Intervention. You CAN have one (for instance, when Daniel was born the social services coordinator in the NICU called for us, to refer him) but you can also just call yourself and request an evaluation. When I called, I was asked why I wanted the evaluation, and then we talked about other areas of development. For instance- does she have any trouble with feeding? How are her social skills? Do I feel like her gross motor or fine motor skills are delayed? Is her hearing okay? Stuff like that. Then that information is given to a family services coordinator who called me to set up the evaluation. (The process is a little different state to state, but this is how it works here.) The evaluation includes me and Lydia (obviously), the family services coordinator, and a speech therapist. (If you were calling for a motor skills evaluation it would include a physical or occupation therapist. For a baby with Down syndrome it would include all three.)
On to the actual evaluation! The first thing we did was go over a family history and a health history. So: who lives here with Lydia, does she go to daycare, is there a family history of delays, has she been a healthy baby/history of ear infections/any hospitalizations. Just background stuff to help them get a feel for her life. Oh, we also went through what a typical day for her looks like, as well as what she typically eats at meals. Then they get into more of the developmental stuff, the kind of questions you get asked at baby well visits. Does she respond to simple commands? Does she use repeated syllables like ma-ma or ba-ba? Can she undress herself? Does she point out pictures in books? Can she stack objects? You get the idea. This all gives them a better idea if she has additional delays. We also talked a lot about receptive language skills- does she understand what we’re saying to her? Because, as the therapist pointed out, she can’t use words if she doesn’t know what they mean. During all this time, Lydia was just running around and playing, which is what they like. Seeing her in action is helpful to them in the evaluation.
The whole thing lasted about an hour (typical) and in the end they said yes, she does qualify for services. At age 2 they like to see at least 50 words. 2 words is a far cry from that. (I asked, and Kansas only requires a 25% delay to qualify. Or 20% in more than one area. And, like in Colorado, a diagnosis like Down syndrome will automatically qualify you.) The therapist agreed with my assessment that her receptive language is likely right on target, and the lack of speaking is probably because she doesn’t WANT to, and not because she can’t. I am guessing that our home environment plays a part in that. For one thing, many (if not all) her needs are anticipated and met before she has to ask for anything. She’s a fourth child. I don’t wait for her to get hungry and ask to eat, I feed everyone at the same time. Stuff like that. The other thing, and this is BIG, is that Brian and I are VERY ACCUSTOMED to handling a non-verbal child. Turns out when you have an almost 4 year old who is just learning to talk, an almost 2 year old who doesn’t say anything doesn’t seem like a big deal. In fact, the therapist asked if there were any words in particular I’d like her to say, anything that might make our life easier and I said something like, “Well, her not talking isn’t actually a PROBLEM for us. Daily life is fine. I just know if I go to her 2 year well visit and she’s still only saying 2 words the pediatrician is going to tell me to call you!” So we laughed about that and in the end decided words like “eat” and “drink” might be good to learn.
So! All the Early Intervention people meet once a week, (or maybe it’s every other week) and at that meeting Lydia will be discussed and assigned to a speech therapist who has space in the schedule. And then the therapy will actually begin! Any questions?